<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en">
<head>  
  <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
  <title>Wild Fire Learning Solutions</title>
  <link href="css/style.css" rel="stylesheet" type="text/css" />
  <script src="datafeed.js" type="text/javascript"></script>

</head>


<body>
<?php
session_start();
?>
<div id="contain">
	<?php include("header.php"); ?>

<!--Navigation and LHS-->
	<div id="leftcol">
		<?php include("menu.php"); ?>
	</div>
<!-- Nav ends -->

<!-- Content (RHS) -->
<div id="content">
<p>
<strong>Order checkout</strong><br />
<strong>Step 1 - Please enter Billing and Shipping Information</strong><br />
Step 2 - Please Verify Accuracy of Order Information and send order<br />
Step 3 - Order Confirmation and Receipt<br />

<form method="post" action="checkout2.php">

<table width="300" border="1" align="left">
	<tr>
		<td colspan="2" bgcolor="#0000FF">
		<div align="center"><strong>Billing Information</strong></div>
		</td>
	</tr>
	<tr>
		<td width="50%">
			<div align="right">First Name</div>
		</td>	
		<td width="50%">
			<input type="text" name="firstname" maxlength="50">
		</td>
	</tr>
	<tr>
		<td width="50%">
			<div align="right">Last Name</div>
		</td>
		<td width="50%">
			<input type="text" name="lastname" maxlength="50">
		</td>
	</tr>
	<tr>
		<td width="50%">
			<div align="right">Billing Address</div>
		</td>
		<td width="50%">
			<input type="text" name="add1" maxlength="50">
		</td>
	</tr>
	<tr>
		<td width="50%">
			<div align="right">Billing Address 2</div>
		</td>
		<td width="50%">
			<input type="text" name="add2" maxlength="50">
		</td>
	</tr>
	<tr>
		<td width="50%">
			<div align="right">City</div>
		</td>
		<td width="50%">
			<input type="text" name="city" maxlength="50">
		</td>
	</tr>
	<tr>
		<td width="50%">
			<div align="right">State</div>
		</td>
		<td width="50%">
			<input type="text" name="state"  size="2" maxlength="2">
		</td>
	</tr>
	<tr>
		<td width="50%">
			<div align="right">Zip</div>
		</td>
		<td width="50%">
			<input type="text" name="zip"  size="5" maxlength="5">
		</td>
	</tr>
	<tr>
		<td width="50%">
			<div align="right">Phone Number</div>
		</td>
		<td width="50%">
			<input type="text" name="phone"  size="12" maxlength="12">
		</td>
	</tr>
	<tr>
		<td width="50%">
			<div align="right">Fax Number</div>
		</td>
		<td width="50%">
			<input type="text" name="fax"  size="12" maxlength="12">
		</td>
	</tr>
	<tr>
		<td width="50%">
			<div align="right">E-Mail Address</div>
		</td>
		<td width="50%">
			<input type="text" name="email" maxlength="50">
		</td>
	</tr>
</table>
<table width="300" border="1">
<tr>
	<td colspan="2">
		<div align="center"><strong>Shipping Information</strong></div>
	</td>
</tr>
<tr>
	<td width="50%">
		<div align="right">Shipping Info same as Billing</div>
	</td>
	<td width="50%">
		<input type="checkbox" name="same">
	</td>
</tr>
<tr>
	<td width="50%">
		<div align="right">First Name</div>
	</td>
	<td width="50%">
		<input type="text" name="shipfirst" maxlength="50">
	</td>
</tr>
<tr>
	<td width="50%">
		<div align="right">Last Name</div>
	</td>
	<td width="50%">
		<input type="text" name="shiplast" maxlength="50">
	</td>
</tr>
<tr>
	<td width="50%">
		<div align="right">Shipping Address</div>
	</td>
	<td width="50%">
		<input type="text" name="shipadd1" maxlength="50">
	</td>
</tr>
<tr>
	<td width="50%">
		<div align="right">Shipping Address2</div>
	</td>
	<td width="50%">
		<input type="text" name="shipadd2" maxlength="50">
	</td>
</tr>
<tr>
	<td width="50%">
		<div align="right">City</div>
	</td>
	<td width="50%">
		<input type="text" name="shipcity" maxlength="50">
	</td>
</tr>
<tr>
	<td width="50%">
		<div align="right">State</div>
	</td>
	<td width="50%">
		<input type="text" name="shipstate" size="2" maxlength="2">
	</td>
</tr>
<tr>
	<td width="50%">
		<div align="right">Zip</div>
	</td>
	<td width="50%">
		<input type="text" name="shipzip" size="5" maxlength="5">
	</td>
</tr>
<tr>
	<td width="50%">
		<div align="right">Phone Number</div>
	</td>
	<td width="50%">
		<input type="text" name="shipphone" size="12" maxlength="12">
	</td>
</tr>
<tr>
	<td width="50%">
		<div align="right">E-Mail Address</div>
	</td>
	<td width="50%">
		<input type="text" name="shipemail" maxlength="50">
	</td>
</tr>
</table>
<p>
<input type="submit" name="Submit" value="Proceed to Next Step --&gt;">
</p>
</form>
</p>
</div>
<!-- content ends (RHS) -->
<?php include("footer.php"); ?>
</div>
</body>
</html>